Tuesday, March 2, 2021

Comments by O Susannah

Showing 2 of 2 comments.

  • I am an American woman who interestingly enough also had a baby in Denmark. I am grateful that I was not on antidepressants at that time or before. I have since been on them a few times for depressive symptoms starting about 15 years later. I do not have a diagnosis of chronic depression, thank God.

    My daughter born in Denmark is now expecting a baby herself. All I can say is that I warned her to avoid any psychiatric medications, no matter what, during the pregnancy. She is in total agreement, and does not need antidepressants for the present…. although she has needed them and taken them in the past for short periods.

    My other daughter has chronic depression and has been on anti-depressant medication for years. She has had great difficulty with recurring suicidal ideation. I honestly don’t know which anti-depressant she is taking as she is 24 and a practicing RN…..I’m on a “need to know” basis and we agree that I don’t need to know. But I warned her about the capacity of SSRI’s to create the exact problem that she is having. She has considerable insight, but she is kinda stuck….when she tries to wean off or switch to a less damaging med, she becomes so seriously anxious and suicidal she becomes unable to work….and jeopardizes her health insurance (which she needs for things like broken legs, God forbid). Her first job out of nursing school forced her to take a long leave of absence and eventually asked her to resign (which she refused to do)–because she sought help with suicidal thoughts! Punished for doing “the right thing.”

    As a practicing health care professional I am acutely aware of the fact that no psychiatric drug is safe for anyone’s pregnancy. As a mother, I am anxious for my children that they not harm my future grandchildren–inadvertently, by working to cope with their own depression or history of depression. Fortunately my pregnant daughter’s docs are all on board with the need to avoid any unneeded medication.

    But my other daughter, who is currently in a valiant fight to cope with chronic depression, is of greater concern to me. She has been depressed off and on since childhood. She has been off and on antidepressants as well. God grant that she doesn’t get pregnant anytime soon and that she can eventually wean off these drugs, whichever ones she is on. But the reality is that this will not happen overnight and she will require extensive support in the years to come, both vocationally and personally. It is hard to say whether or not she has a realistic chance of having children under these circumstances. She would never intentionally conceive if she could not go off of anti-depressants as she is very aware of the birth defect risk.

    For her, depression is life-threatening. When it is at its worst she has to fight off suicide like an invading assailant. When it is at its least, she has to fight to get out of bed and function to work and support herself. This is no passing malaise.

    My grandmother committed suicide in her late 30’s. My mother and her brother were 7 and 4 years old. Depression has left a horrible mark on my family and I myself work everyday to maximize my own mental health because I always have the family history in the back of my mind. I am proud of my mother that she lived to be 86 years old, but I know that it was a struggle for her as well. I don’t know why my own life has been as charmed as it has, but somehow I have had it much easier…. and I do NOT owe it to taking antidepressants.

    Dr. Healy, you are so right! This paper implies that women with chronic depression are damned if they do and damned if they don’t when it comes to motherhood. If they try to be mothers without the medication the outcome will be terrible, simply from depression alone. If they try to be mothers while taking antidepressants they are at a high risk for all kinds of birth defects and that could be a terrible outcome. The solution? It would seem that a woman with chronic or recurring depression (according to the study) perhaps should not have children. Hmmm. Sounds like a study that might support the proponents of eugenics.

    My RN daughter is a stubborn and determined soul and she will work it out. I have faith in her. It’s not so easy for most women with depression. We have to do what we can to help.

  • Thank you, Bob. Your article has brought so many things to mind, as have all the insightful comments I have read. Here is my contribution.

    Black box warnings are supposed to be just that: a warning. The black box means that it is “the” sternest warning possible. Doctors prescribe medicines every day that have black box warnings, and most of the time neither we nor they think anything of them. In the case of psychiatric medicines, the big problem occurs when a doctor prescribes a black box psychiatric medication to a child or youth and the patient commits suicide.

    We are all horribly upset when we personally know a child or young adult who commits suicide. I’m sure this guy Gibbons is just as upset about his friend’s child or a neighborhood young adult commits suicide. The big difference is that when we find out that this child or young adult was on an antidepressant with a black box warning for suicide, we are outraged….because we have prior knowledge and understanding that these medications may not have helped this person at all, but may have actually caused or precipitated this death.

    Gibbons, be he Mr. or Dr., is someone who is philosophically FOR psychiatric medication for most or even all individuals who ever had psychiatric symptoms. He, I am fairly sure, believes that this child or young adult who was on antidepressant medication and took his or her own life did so IN SPITE of being medicated. Gibbons, more than likely, believes that this child or young adult was either off his or her meds, mixed meds with drugs or alcohol or was “too far gone” or “would have taken his or her life no matter what was done for him/her.” Perhaps Gibbons believes that the child or young adult couldn’t contact his or her therapist/psychiatrist or that the therapist/psychiatrist was not a good one. Perhaps in some way, this tragic young suicide was not compliant. But Mr./Dr. Gibbons does not believe that psychiatric drugs caused an unnecessary death. If he did, he would be in here agreeing with us!

    The notion that removing the black box will somehow decrease the suicide rate is a very poor exercise in logic. Any doctor who is reputable will not hesitate to prescribe a black box medication if it is the best one to treat the problem, whatever it is. Surely not all psychiatrists are unethical.

    His logic is that, because the black box warning is on these antidepressants, doctors will hesitate to prescribe them to the children and young adults who “so desperately need them.” Poppycock!! With the plethora of antidepressants out there, any psychiatrist with a conscience can correctly prescribe antidepressants to suicidal children and young adults that do not have the black box warning. “When there is a will there’s a way” isn’t just some catchy phrase to put in a fortune cookie.

    As professionals in the mental health community in various capacities, we should all encourage anyone who is suicidal to obtain psychiatric help. However, we should also encourage everyone giving or receiving psychiatric help to give and receive it at its lowest concentration of evil, that is, the lowest dose of the least dangerous drugs and that they should also receive liberal doses of non-pharmacological help: psychotherapy, facilitation of family/friendships, social support webs (such as church/temple)and good old fashioned activities (hobbies, clubs, groups, etc.).

    This is how I survive in this crazy world of mental health. I do my work and the rest I “encourage.” Let’s all make a difference where we can in what way we are able. I’m sure my survival will be a little more tolerable from here on out by learning from you folks.

    Susanna Maklakov, M.S., OT/L